钙通道阻滞剂与血管紧张素II 1型受体阻滞剂联合治疗。
Combined therapy with a calcium channel blocker and an angiotensin II type 1 receptor blocker.
作者信息
Bakris George L
机构信息
University of Chicago, Pritzker School of Medicine, Chicago, IL 60637, USA.
出版信息
J Clin Hypertens (Greenwich). 2008 Jan;10(1 Suppl 1):27-32. doi: 10.1111/j.1524-6175.2007.08029.x.
Abstract
Fixed-dosed combination regimens consisting of a calcium channel blocker and an angiotensin II type 1 receptor blocker represent a new addition to the available antihypertensive treatment options. Clinical trials demonstrate that both the dihydropyridine calcium channel blocker amlodipine and angiotensin II receptor blockers are effective agents for the management of hypertension in individuals with or without cardiovascular disease. When combined, these 2 classes of agents have complementary effects on blood pressure, as each targets separate signaling pathways in the vasculature pivotal to the regulation of vascular function. In clinical trials this combination has demonstrated better efficacy, defined by time to reach blood pressure targets as well as levels of blood pressure achieved, compared with the individual agents. In a comparative trial, a combination of amlodipine plus valsartan (an angiotensin II receptor blocker) also produced greater reductions in blood pressure compared with a combination of lisinopril (an angiotensin-converting enzyme inhibitor) and hydrochlorothiazide. The combination of amlodipine and an angiotensin II receptor blocker is well tolerated, including in patients with stage 2 hypertension and the elderly.
摘要
由钙通道阻滞剂和血管紧张素II 1型受体阻滞剂组成的固定剂量复方制剂是现有抗高血压治疗选择中的新成员。临床试验表明，二氢吡啶类钙通道阻滞剂氨氯地平和血管紧张素II受体阻滞剂都是治疗有或无心血管疾病个体高血压的有效药物。联合使用时，这两类药物对血压具有互补作用，因为它们各自作用于血管系统中对血管功能调节至关重要的不同信号通路。在临床试验中，与单药治疗相比，这种联合治疗在达到血压目标的时间以及所达到的血压水平方面均显示出更好的疗效。在一项对比试验中，氨氯地平加缬沙坦（一种血管紧张素II受体阻滞剂）的联合用药与赖诺普利（一种血管紧张素转换酶抑制剂）和氢氯噻嗪的联合用药相比，也能使血压有更大幅度的降低。氨氯地平和血管紧张素II受体阻滞剂的联合用药耐受性良好，包括2级高血压患者和老年患者。
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